Inflammatory aneurysms of the abdominal aorta with associated ureteric obstruction or medial deviation

Six cases of ureteric involvement in the retroperitoneal fibrosis associated with inflammatory aneurysms of the abdominal aorta are described. Though of uncertain aetiology, such aneurysms appear to constitute a distinct disease entity. The treatment of choice of an inflammatory aneurysm with ureteric obstruction is aneurysmectomy and ureterolysis. In unfit patients, ureterolysis alone or the administration of steroids is indicated. Pre-operative diagnosis of aneurysms of the inflammatory type may be possible with the aid of intravenous urography and erythrocyte sedimentation rate determination. The value of ultrasonography and computed tomography in diagnosis is still to be proven. Some modification of the standard technique of aneurysmectomy may be necessary when other retroperitoneal structures have been rendered inseparable from the aortic wall due to their involvement in the dense inflammatory fibrous reaction.